Kornimate/medical-research-clean huggingface dataset:
genetic determinants of sudden cardiac death

Conditions: Cardiovascular Diseases; Heart Diseases; Death, Sudden, Cardiac; Ventricular Arrhythmia; Arrhythmia

Summary: to evaluate whether genetic variation in selected candidate genes is associated with risk of sudden cardiac death in the general population.

background sudden cardiac death (scd) affects 400,000 individuals each year in the u.s. alone. over half have no evidence of heart disease prior to death, and our ability to identify those at risk and, therefore prevent scd, is poor. mutations in cardiac ion channel genes including scn5a, kcnq1, kcnh2, kcne1, kcne2 and ryr2 have been implicated in monogenic traits with high risk of scd, such as the long-qt, brugada, sudden infant death syndrome (sids), and catecholaminergic polymorphic ventricular tachycardia. alterations in ion channel function can result in life-threatening ventricular arrhythmias in diverse disease states. therefore, sequence variants in these genes that alter function or transcription of these ion channels may confer a predisposition to ventricular arrhythmia and scd in broader populations. design narrative this research program proposes to determine if sequence variants in the above and other candidate genes are associated with an increased risk of scd in apparently-healthy populations. cases of scd will be assembled from 5 nih-funded prospective cohorts with a total of 106,314 individuals with existent blood samples. all cohorts are exceptionally well-characterized with respect to environmental exposures and have collected medical records on cardiovascular endpoints. we will characterize all coding sequence variation and selected non-coding sequence variation among 100 cases and controls from these cohorts for the 6 genes. we will then employ a nested case-control design and conditional logistic regression to test for associations between haplotypes (haplotype tag snps) in both coding and non-coding regions of candidate genes and scd risk. we will also test directly for associations between single loci that may have functional significance and scd risk. an estimated 600 cases of well-documented scd will be confirmed over the first 3 years of the grant period, and these cases will be matched on age, sex, ethnicity, and geographic location to two control subjects from the same cohort. in addition, based upon known sex difference in the phenotypic expression of the candidate genes in the primary arrhythmic disorders, we will specifically examine sex difference in the risk of scd associated with sequence variation in these genes. the findings generated will have substantial implications for our understanding of the scd syndrome and risk stratification in the general population.

Eligibility criteria:
no eligibility criteria.
virtual reality mirror therapy for those with acquired brain injury: a clinical pilot study

Conditions: Acquired Brain Injury Including Stroke

Summary: the goal of this study is to investigate the effects of virtual reality based mirror therapy (vmt) on individuals with acquired brain injury when compared to a control group receiving traditional mirror therapy (tmt). this is a randomized controlled pilot study in which patients with hemiplegia will be assigned to vmt or tmt and the impact on upper extremity function will be observed.

the investigators are currently running a mirror therapy pilot project in the hamilton health sciences rehabilitation program. mirror therapy has been successfully used with people that have injuries such as strokes or other types of brain injuries that affect movement on one side of their body. mirror therapy involves placing a mirror over the affected limb and angling it to reflect the unaffected limb. this creates a visual illusion that moving the unaffected limb also results in movement in the affected limb. this is theorized to aid recovery of the motor system in the brain. virtual reality (vr) can also be used with people with strokes and brain injuries and many studies of vr have shown positive results. in this study, the investigators will combine vr and mirror therapy. the investigators have designed a special new system that uses vr headset to make it appear that both limbs are moving when only the unaffected limb is moving. the investigators are going to do this by having people complete virtual tasks wearing this specially programmed headset. the tasks are everyday activities that a person might perform using two hands. ultimately, the investigators hope to determine whether there is any difference between vr mirror therapy and regular mirror therapy in improving upper limb function.

Eligibility criteria:
inclusion criteria: * diagnosis of stroke or brain injury, including ischemic or hemorrhagic strokes, confirmed by radio logical evidence and evidence suggesting injury primarily to one side and exhibited by hemiplegia * their post injury time is between 2 weeks and 2 years * patients are between the age of 16 and 65 years old exclusion criteria: * greater than stage 4 on the cmsa * behavioral impairments that may prevent safe or consistent participation

Keywords: acquired brain injury stroke rehabilitation
less frequency hemodialysis and covid-19

Conditions: End Stage Renal Disease

Summary: facing the unusual situation imposed by the coronavirus disease, the aim of this study is to evaluate the risk and effects of less frequent hemodialysis on prevalent patients

the novel coronavirus disease (covid-19), also known as covid-19 (and sars-cov2) by the world health organization, is a rapidly evolving pandemic. the outbreak is expected to infect a large portion of the world population, and a case fatality rate of 1-3% represents a significant mortality and healthcare burden. in common with other viral diseases, mortality is higher in elderly patients with high comorbidity. the impressive figures of transmission in different communities underline the need for reorganization of efforts to limit contagion, particularly in crowded settings. hemodialysis centres represents a specific setting in which many patients are repeatedly treated in the same area at the same time. dialysis patients constitute a susceptible population because of their older age, high comorbidity burden and their less efficient immune system. therefore, they are more prone to develop severe infectious diseases than the general population.. moreover, if infected, the requirements of specialized resources and staff is further complicated by requirements for isolation, control and prevention, putting healthcare systems under additional strain. therefore, all measures to slow and to control unmanageably high incidence rates must be taken very seriously. the routine treatment usually requires three dialysis sessions per week further, some patients must travel long distances to the dialysis centre. one option to reduce the higher risk of these patients is to reduce the frequency of dialysis sessions.however, the potential benefits of reduced risk may be associated with higher interdialytic weight gain and inadequate dialysis, two factors that increase the risk of mortality. furthermore, the impact of reduced frequency on anemia and nutrition have not been extensively studied.

Eligibility criteria:
inclusion criteria: * more than 30 days of chronic ambulatory in-center hemodialysis exclusion criteria: * more than three sessions a week * amputated lower limbs

Keywords: covid-19 dialysis less frequency hemodialysis ultrafiltration rate anemia nutrition
statin-vap statin-vap - statins and ventilator-associated pneumonia

Conditions: Pneumonia

Summary: the objective is to assess the efficacy and safety of oral simvastatin in patients with a suspicion of ventilator-associated pneumonia (vap). the hypothesis of this study is that simvastatin therapy will improve mortality in patients a suspicion of vap.

when a patient will present a suspicion of vap (clinical pulmonary infection score modified ≥ 5), simvastatin or placebo will be administered with antibiotics. quantitative cultures will be performed for microbiological confirmation of vap. simvastatin or placebo will be administered through an enteral feeding tube or administered orally when patients are able to safely take oral medications. the type and placement of the enteral feeding tube (nasogastric, nasoenteric, peg, orogastric, oroenteric, etc.) and the ability to safely take oral medications will be determined by the patient's primary team. study drug will be blinded with an identical appearing placebo. sequential organ failure assessment score (sofa), and various blood factors will be measured during treatment.

Eligibility criteria:
inclusion criteria: * duration of mechanical ventilation \> 48 h * first episode of suspicion of vap with a clinical pulmonary infection score modified ≥ 5 * bal, plugged telescopic catheter and/or tracheal aspirates quantitative cultures performed prior administration of antibiotics * informed consent exclusion criteria: * statin treatment received under mechanical ventilation * age less than 18 years * pregnancy * unable to receive or unlikely to absorb enteral study drug * patient, surrogate, or physician not committed to full support ). * moribund patient with a saps ii score \> 75 * simvastatin specific exclusions allergy or intolerance to statins physician insistence for the use or avoidance of statins during the current hospitalization ck , alt or ast \> 5 times the upper limit of normal receiving cyclosporine, gemfibrozil, lopinavir, ritonavir itraconazole, kétoconazole, érythromycine, clarithromycine, télithromycine, néfazodone, verapamil, diltiazem * severe chronic liver disease

Keywords: suspicion of ventilator-associated pneumonia
evaluating the pharmacokinetics and patient outcomes of buprenorphine microdosing

Conditions: Opioid Use Disorder; Opioid Withdrawal

Summary: there are more than 2.1 million people in the united states with opioid use disorder, and according to preliminary data from the us centers for disease control and prevention opioid overdose deaths rose 36% to more than 69,000 deaths in 2020. treatment with buprenorphine or methadone reduces overdose deaths in patients with opioid use disorder. however, most patients with opioid use disorder do not receive treatment. in addition to the rising rates of morbidity and mortality, the healthcare, social, and societal costs of the opioid epidemic are roughly one trillion dollars annually. rapidly scalable strategies are needed to increase access to treatment and improve treatment retention. the investigators propose a novel buprenorphine micro-dosing study to evaluate the pharmacokinetics, treatment retention, and qualitative outcomes in participants transitioning from methadone maintenance therapy to buprenorphine using a micro-dosing initiation in the outpatient setting. the proposed study will report participant pharmacokinetics, treatment retention, clinical opiate withdrawal scale (cows) score, treatment satisfaction questionnaire for medication (tsqm) score, and other qualitative outcomes.


Eligibility criteria:
inclusion criteria: * participants will include adults (at least 18 years of age) who have been enrolled and receiving consistent treatment in the methadone program for at least 6 months. exclusion criteria: * participants will be excluded if they are on a methadone dose \> 80 mg, have concurrent alcohol use or benzodiazepine use disorder, require opioids for a pain-related diagnosis, are a current suicide or homicide risk, have a current psychotic disorder (dsm-v) or untreated major depression, have a life-threatening or unstable medical problem, or are pregnant.
pharmacogenetic of salbutamol in pediatric asthma crisis

Conditions: Asthma

Summary: this study is designed to identify the genetic factors which can be implicated in the salbutamol responsiveness for asthmatic children in pediatric emergency department

patients from 6 to 16 years old consulting for an acute asthma exacerbation and receiving a treatment by salbutamol according to the usual care could be recruited.saliva from patient were collected using oragen®.dna og-500 kit or swabs.based on literature review, four snp were chosen:adbr2 gene), arg gene, and gsnor gene.

Eligibility criteria:
inclusion criteria: * children * 6-16 years old * asthmatic patients * consulting for an exacerbation in a pediatric emergency department * parental informed consent exclusion criteria: * comorbidity * peak flow no available * pneumonia
targeted screening for taenia solium tapeworms

Conditions: Taenia Solium Taeniasis

Summary: the purpose of this study is to determine whether screening and treatment of tapeworm carriers can decrease community transmission of taenia solium parasitic infection.


Eligibility criteria:
inclusion criteria: * all community members are eligible exclusion criteria: * inability to provide informed consent

Keywords: taenia solium cysticercosis neurocysticercosis
the role of small bowel ultrasound in initiation of infliximab in crohn's disease patients

Conditions: Inflammatory Bowel Disease; Crohn's Disease

Summary: goal is to prospectively determine if stool calprotectin and change in bowel wall thickness and hyperemia, as seen on small bowel ultrasound, at week 0, 14, and 54 can be used to predict response at week 54 to infliximab in pediatric patients with small bowel crohn's disease.

we will examine whether non-invasive disease monitoring tools such as bowel wall thickness as measured by small bowel ultrasound (sbus) and mucosal inflammation as measured by fecal calprotectin, are independently associated with infliximab durability.

Eligibility criteria:
inclusion criteria: * age 6-23 years * initiating infliximab therapy * crohns disease involving the distal small bowel +/- proximal colon * willingness to undergo sbus and fecal calprotectin collection prior to starting infliximab and again at week 14 and week 54 * able to give consent by patient and/or legal guardian exclusion criteria: * ulcerative colitis or non-crohn's disease patients * lack of small bowel disease * patients started on alternative therapy * unable or unwilling to provide consent

Keywords: inflammatory bowel disease crohn's disease pediatric ibd small bowel ultrasound infliximab
technology intensified diabetes education study in african americans

Conditions: Diabetes Mellitus, Type 2; Diabetes Mellitus, Adult-Onset; Diabetes Mellitus, Non-Insulin-Dependent; Diabetes Mellitus, Noninsulin Dependent; Diabetes Mellitus, Type II

Summary: the purpose of this study is to test the usefulness of an intervention that combines technology with diabetes education and skills training. this study has been designed specifically for african americans with poorly controlled type 2 diabetes.

african americans (aa) with type 2 diabetes (t2dm) have higher prevalence of diabetes, poorer metabolic control (i.e. poorer blood glucose, blood pressure, and lipid control), and greater risk for complications and death compared to white americans. hemoglobin a1c (hba1c) is the primary marker for glycemic control and is a strong independent predictor of development of complications and increased mortality in t2dm. key self-care behaviors that influence glycemic control (and hba1c) include diet, physical activity, self-monitoring of blood glucose and medication adherence. systematic review of multiple randomized clinical trials (rcts) show that self-care interventions that include diabetes education and skills training are effective in improving metabolic control in diabetes. recent findings indicate that patients with diabetes, especially ethnic minority patients, prefer telephone-delivered diabetes education to group visits or internet-based education. multiple rcts have documented the effectiveness of telephone-delivered self-care interventions in t2dm. preliminary data from our group also suggest that a culturally-tailored telephone-delivered diabetes education and skills training intervention is an effective strategy to improve metabolic control in aa patients with t2dm. this study provides a unique opportunity to address gaps in the literature by testing the efficacy of a technology-intensified diabetes education/skills training (tides) intervention in aas with poorly controlled t2dm. the long-term goal of the project is to identify effective strategies to improve metabolic control and hence reduce diabetes complications and mortality rates in aas with t2dm.

Eligibility criteria:
inclusion criteria: * age ≥21 years * clinical diagnosis of t2dm and hba1c ≥8% at the screening visit * self-identified as aa * subject must be willing to use the fora monitoring system for 12 months * subjects must be able to communicate in english * subjects must have access to a telephone (landline for data uploads) for the study period exclusion criteria: * mental confusion on interview suggesting significant dementia * participation in other diabetes clinical trials * alcohol or drug abuse/dependency * active psychosis or acute mental disorder * life expectancy \<12 months

Keywords: diabetes mellitus, type 2 diabetes mellitus, adult-onset diabetes mellitus, non-insulin-dependent diabetes mellitus, noninsulin dependent diabetes mellitus, type ii african americans blacks non-hispanic blacks randomized control trial controlled clinical trial behavioral research behavioral medicine
vascular injury in mechanical ventilation: a proof-of-concept study

Conditions: Mechanical Ventilation Complication; Vascular Injury; Endothelial Dysfunction

Summary: investigation of the effect of mechanical ventilation on biomarkers of microvascular damage

the objective of this study is to determine the effect of mechanical ventilation (mv) on endothelial biomarkers associated with ventilator-induced vascular injury (vivi), and determine the correlation of these biomarkers with non-invasive microvascular perfusion monitoring data and semaphorin 3e levels. blood samples will be collected immediately pre-operatively and post-operatively. biomarkers will be expressed as an absolute value and as a relative percentage change from baseline to account for inter-individual variability. hemodynamic and surgical variables will be extracted from the or data: blood pressure, oxygen saturation, blood loss, fluid administration, length of surgery, and mv parameters such as tidal volume, inspired oxygen, respiratory rate, and positive end-expiratory pressure. during surgery, patients will be monitored using a non-invasive near-infrared spectroscopy technique to quantify skeletal muscle microvascular perfusion. these devices will be applied immediately prior to induction of anesthetic and data collected until immediately prior to transfer to the post-anesthesia care unit.

Eligibility criteria:
inclusion criteria: * age 18 years or greater * patients undergoing elective orthopedic, endourologic, or plastic surgery procedure which is amenable to both general anesthetic or regional/neuraxial anesthesia exclusion criteria: * emergency surgery * polytrauma * tourniquet use * controlled hypotension * mechanical ventilation less than 60 minutes in duration * american society of anesthesiologists class 4 or greater * status postpneumonectomy * pulmonary hypertension * oxygen therapy during last month * severe obesity (body mass index ≥40 kg/m2) * immunosuppression within 3 months * diagnosed infection * shock
psychological intervention modifies outcome of patients with implantable cardioverter defibrillator: the peace study

Conditions: Implantable Defibrillator User

Summary: this study aims to investigate whether follow-up with a psychologist has an impact on the outcome of patients with an implantable automated defibrillator.

the implantation of an icd in primary prevention is known to increase the rates of anxiety and depression, which can reach up to 45% and 35% respectively in this patient population. several studies have reported that psychological accompaniment for these patients can alleviate the symptoms of anxiety and/or depression. therefore, we aim to investigate the utility of psychological follow-up for a period of 1 year after first implantation of an icd for primary prevention.

Eligibility criteria:
inclusion criteria: * adult patients (aged 18 years or over) * indication for implantation of an icd for primary prophylaxis * written informed consent provided * patients with social security coverage exclusion criteria: * patients under legal tutorship or guardianship * patients with no social security coverage * patients still within the exclusion period after participation in another clinical trial, as indicated by the national registry of clinical trial volunteers * patients unable to complete the questionnaires (language barriers, mentally deficient, illiteracy or dementia) * patients awaiting heart transplant * patients who refuse to provide written informed consent

Keywords: implantable cardioverter defibrillator primary prevention psychological follow-up anxiety depression quality of life
an extension study of anavex2-73 in patients with mild to moderate alzheimer's disease

Conditions: Alzheimer's Disease

Summary: this open label extension study is designed to provide continued access to anavex 2-73 for eligible subjects with mild to moderate alzheimer's disease who have previously participated in the anavex sponsored study anavex2-73-002.


Eligibility criteria:
inclusion criteria: * previous exposure to anavex2-73 via participation in phase 2a study of anavex2-73 adaptive-trial-design with repeated doses, mtd finding, pharmacodynamic and bioavailability evaluation in patients with mild to moderate alzheimer's disease with a 12-month open label follow-up period (anavex2-73-002) exclusion criteria: * have not previously participated phase 2a study of anavex2-73 adaptive-trial-design with repeated doses, mtd finding, pharmacodynamic and bioavailability evaluation in patients with mild to moderate alzheimer's disease with a 12-month open label follow-up period (anavex2-73-002)
identifying prostate brachytherapy seeds using mri

Conditions: Prostate Cancer Patients Who Have Brachytherapy Seed Implant

Summary: this study will look at the feasibility of using a type of magnetic resonance imaging called susceptibility weighted imaging (swi) to detect your implanted radioactive seeds. researchers hope that using swi will eliminate the need to use ct imaging to detect your implanted radioactive seeds. this study will also see if the mri seed detection is as effective as current standard practice of seed detection (routine mri and ct imaging). this technique would be beneficial for brachytherapy without the need to fuse the mri and ct images, as is done currently.


Eligibility criteria:
inclusion criteria: 1. at least 18 years old 2. histologic diagnosis of adenocarcinoma of the prostate 3. no contraindications for pelvic body mri 4. patients undergoing ldr brachytherapy at pmh and scheduled for post implant analysis with ct-mr (standard at pmh) 5. ability to provide written informed consent to participate in the study exclusion criteria: 1. contraindication for pelvic body mri 2. patient not willing/consenting for this study

Keywords: prostate cancer brachytherapy seed implant
treatment of localized low grade lymphomas

Conditions: Lymphoma, Low-Grade

Summary: to compare localiezd radiotherapy to localized radiotherapy followed by 6 cycles of chemotherapy in the treatment of localiezd low grade lymphoma

the standard treatment ol localized low grade lymphomas is radiotherapy alone can offer long term remissions to some patients . no study have clearly demonstrated the interest of chemotherapy. the purpose of the study is to determine wether prednisone administrated after first line local radiotherapy (30 gy) can pre in the treatment of localized low grade lymphomas of adult patients

Eligibility criteria:
inclusion criteria: * low grade lymphoma defined according to the ann arbor classification * localized exclusion criteria: * subjects unable to signed informed consent * pregnancy

Keywords: localized low grade lymphoma chemotherapy radiotherapy molecular analyses primary